Abstract 14916: Difference of Neointimal Growth Patterns in Bifurcation Lesion among 4 Kinds of Drug-Eluting Stents : Optical Coherence Tomography Study.
Background: The bifurcation lesion is a one of major risk factors for stent thrombosis, but the detailed evaluation of neointimal formation at bifurcation lesion after implantation of drug-eluting stents (DES) were not performed.
Methods: We assessed the neointimal growth post DES implantation at bifurcation lesion using optical coherence tomography (OCT). Follow-up OCT images at 6 to 8 months after the procedures were performed in 66 bifurcation lesions of 4 kinds of DES including 15 sirolimus (SES), 17 paclitaxel (PES) as 1st generation DES and 16 zotarolimus (ZES), 18 everolimus (EES) as 2nd generation DES, which had undergone DES implantation with crossover the side branch (branch diameter > 1.5mm). Cross-sectional images of the bifurcation lesion using OCT were analyzed every 450µm. All images were divided into the following two groups: T-SB group was defined as the 180 degree half image towards the origin of the side branch and N-SB group was defined as the other 180 degree half image opposite the side branch. We compared the incidence of uncovered struts (IUS) and averaged neointimal thickness (ANT) between the two groups among 4 kinds of DES.
Results: There were no significant differences of IUS between N-SB and T-SB groups in 2nd generation DES while in 1st generation DES, IUS of N-SB and T-SB groups showed significant differences (table). In addition, IUS of 1st generation DES were significantly higher than that of 2nd generation DES (all p < 0.001). ANT of N-SB group was significantly higher than that of T-SB group in PES, ZES and EES, but SES, whose IUS showed worst value, revealed similar ANT between the two groups. ANT of EES was significantly lower than that of ZES in both N-SB and T-SB groups (both p <0.0001).
Conclusions: In the bifurcation lesion, OCT revealed more homogeneous neointimal coverage in 2nd generation DES than 1st generation one. Thickness of EES neointimal coverage was thinner than ZES. Different neointmal growth patterns showed among SES, PES, ZES and EES.
- © 2011 by American Heart Association, Inc.